MS. GAIL DOLORES JERIDEAU-PRATT


Address: 30251 Channel Way Dr, Canyon Lake, CA 92587-7986
Phone: 9512462640

MS. GAIL DOLORES JERIDEAU-PRATT (NPI# 1154517092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154517092
Entity Type Individual
Full Name MS. GAIL DOLORES JERIDEAU-PRATT
Credential R.N.
Practice Address 30251 Channel Way Dr
Canyon Lake
CA 92587-7986
Practice Telephone 9512462640
Mailing Telephone 9512462640
Enumeration Date 2007-09-24
Last Update Date 2007-09-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WP0809X Registered Nurse
Specialization: Psych/Mental Health, Adult
459851 CA Nursing Service Providers

Office Location

Street Address 30251 CHANNEL WAY DR
City CANYON LAKE
State CA
Zip Code 92587-7986

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1306165709 Jennifer D Lewis Massage Therapist 23717 Cruise Circle Dr, Canyon Lake, CA 92587 2010-05-25
1902901630 William Brent Robinson Dentist 31570 Railroad Canyon Rd, Ste 101, Canyon Lake, CA 92587 2006-09-14
1629582820 Ashleigh Brown Specialist/Technologist 30060 Skippers Way Dr, Canyon Lake, CA 92587-7404 2017-11-27
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1548748635 Mason Dental Hygiene Group Dental Hygienist 30168 Point Marina Dr, Canyon Lake, CA 92587-7411 2018-08-01
1720633027 Amy Lynn Mason Dental Hygienist 30168 Point Marina Dr, Canyon Lake, CA 92587-7411 2019-08-05
1477752558 Roger Strong Dentist 30389 Point Marina Dr, Canyon Lake, CA 92587-7413 2007-07-17
1508193392 Ku Il Lee Chiropractor 29806 Santa Maria Dr, Canyon Lake, CA 92587-7426 2009-11-16
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Taxonomy Information

Taxonomy Code 163WP0809X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health, Adult

Taxonomy Definition

Definition to come...

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Competitor

Search similar providers

City CANYON LAKE
Zip Code 92587

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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